Dust•Bacteria, •Fungi, •Farmer’sLung (is a hypersensitivity pneumonitis induced by the inhalation of biologic dusts coming from hay dust or mold spores or other agricultural products.•Pigeon Breeder’sLung, caused the exposure to avian proteins present in the dry dust of the droppings and sometimes in the feathers of a variety of birds.
• NON-Caseating Granulomas are the RULE • “Asteroid” bodies within these granulomas are virtually diagnostic, but hard to find • Note: sarcoidosis is NOT limited to the lungs.
3. SMOKING RELATED • DIP ( D esquamative I nterstitial P neumonia) because it looks like the alveolar wall “epithelium” is peeling off into the alveolus – M>>F – CIGARETTES – 100% Survival Alveolar Macrophages
4. PAP (Pulmonary Alveolar Proteinosis ) • Very RARE, usually acquired • Proteinaceous Material in Alveoli • MINIMAL cellular inflammatory infiltrate • Like Pulmonary Edema, but MUCH Protein
2. Extrinsic disorders of restrictive lung diseases • Are extra-pulmonary diseases due to • Diseases of the chest wall, • Disease of the pleura, • Damage to the nerve • Damage to the respiratory muscles • They resulted in • lung restriction, • impaired ventilatory function • respiratory failure (eg, non-muscular diseases of the chest wall, neuromuscular disorders ).
VASCULAR PULMONARY DISEASES THREE TYPES 1. PULMONARY EMBOLISM (with or usually WITHOUT infarction) 2. PULMONARY HYPERTENSION , leading to cor pulmonale 3. HEMORRHAGIC SYNDROMES – GOODPASTURE SYNDROME – HEMOSIDEROSIS , idiopathic – WEGENER GRANULOMATOSIS
Pulmonary Embolism • Usually secondary to debilitated states with immobilization, or following surgery • Usually deep leg and deep pelvic veins (DVT), NOT superficial veins • Follows Virchow’s triad, i.e., 1) flow problems, 2) endothelial disruption, 3) hypercoagulabilty • Usually do NOT infarct, usually ventilate • When they DO infarct, the infarct is hemorrhagic • Decreased PO2, acute chest pain, V/Q MIS-match • DX: Chest CT, V/Q scan, angiogram • RX: short term heparin, then long term coumadin
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- Fall '19